Results of treatment of ventral hernias and adhesive peritoneal disease in patients after advanced peritonitis

Goal. To compare the results of treatment of postoperative ventral hernia without and after enthenolysis in patients with advanced purulent peritonitis. Materials and methods. The results of treatment of 60 patients who suffered from widespread purulent peritonitis, after which postoperative ventral hernia and adhesive peritoneal disease developed, were studied. In the first group (n = 30), the treatment consisted of herniation with over-aponeurotic endoprosthesis of the abdominal wall without the implementation of enthenolysis. In the second group (n = 30), after herniation, a thorough enthenolysis was performed, after which the anti-adhesive drug "Mesogel” was injected into the abdominal cavity, and the final stage of the operation was performed similarly to the first group. In the immediate postoperative period, the integral coefficient of dysfunction and the distance of intestinal sliding were calculated, and in the long term, the quality of life of patients and the result of treatment were determined on a 4-point scale. Results. In the second group, the integral coefficient of dysfunction decreased by 0.5±0.1 points.and the bowel sliding distance increased by 0.65±0.1 cm. When studying the quality of life of patients in the second group, an increase in the physical component of health by 11.6% and psychological by 11.9% was noted, which led to an increase in excellent treatment results by 33.3%, good by 30%, a decrease in satisfactory by 56.6% and the absence of episodes of acute adhesive intestinal obstruction. Conclusion: carrying out of enthenolysis with the introduction of the anti-adhesive drug "Mesogel” during herniation can improve the quality of life of patients